Southwest Districk Ambulance Service Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

0341 Issued in IN

Legal business name

SOUTHWEST DISTRICK AMBULANCE SERVICE INC

Practice address

7984 W US Highway 40
Knightstown, IN 46148-9411

Phone

(765) 345-9712

Fax

(765) 345-9713

NPI assigned

Jul 19, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ben Madison

Title

Executive Secretary

Phone

(317) 775-6753

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1881693224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56002",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462560002",
            "telephone_number": "317-849-6628",
            "fax_number": "317-849-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7984 W US HIGHWAY 40",
            "city": "KNIGHTSTOWN",
            "state": "IN",
            "postal_code": "461489411",
            "telephone_number": "765-345-9712",
            "fax_number": "765-345-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DISTRICK AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "EXECUTIVE SECRETARY",
        "authorized_official_telephone_number": "317-775-6753"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IN",
            "license": "0341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590011862",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200122950A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000180914",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Phelps, COTA
• Amy Meyer Ploeger, DDS
• Richard a Armstrong DDS, PC
• Aimee Rodeghero, MA, CCC-SLP
• Cornelius J Shaneyfelt, O.D.
• State of Indiana
• Benjamin Wright

• Ambulance in Knightstown, IN
• Providers in Knightstown, IN by specialty
• Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.